Just Diagnosed

I was dx'd 2 weeks ago after excisional biopsy for microcalcifications.  The pathology report reads "speciman shows extensive intraductal carcinoma, predominantly cribriform & micropapillary patterns.  Intraductal carcinoma is present throughout measuring to at least 2.5cm & extends to the surgical resection margin in numerous regions.  Numerous small foci of microinvasive carcinoma are associated w/the intraductal carcinoma.  The invasive component is est. to be about 8mm microscopically & is very close to (about 1mm) but not definively at the resection margins."  It goes on to say that the tumor is ductal & moderately differentiated, ER/PR+. I'm going to have a mastectomy & SNB in early August. I understand that the intraductal is DCIS; the invasion is a "leak", bad term but that's the only way I can describe it.  My questions are "is this area of DCIS & invasion considered a tumor, is the invasion & DCIS all one area/tumor? does this now measure to about 3.3cm?"  I'm confused, I would ask my surgeon but he is out of town & I'm leaving soon for 2 weeks & come back for the mastectomy & SNB.  Thanks so much.

[CCF-RN,MSN-rf]

Dear carkosh:  The first thing to do is clarify that this is ductal carcimoma in situ - which it appears that it is.  But the specimen contains numerous small foci of microinvasive carcinoma.  This suggests that there is invasive disease present throughout the specimen - although the report then says 8mm.  If this is the only focus of invasion - then the recommendation sounds appropriate.  Technically all of the disease is considered a "tumor" but the invasive component is the part that is considered for staging purposes.  The size of the invasive component is the critical information (for example 8mm) if it is only one focus.  If it is more than one focus, then the size of the largest focus is considered.

[surgeon]

Right: for staging purposes, only the size of the invasive component is critical. In other words, you don't have a 3 cm tumor. And the fact that the only invasive component found is "microinvasive" means it's still very early, with a very high cure rate.

[carkosh]

Thank you, Nurse & Surgeon, for the information.  My question is now answered & I can go on my trip with a little more peace of mind & come back ready to fight this!